Peru-JHU TMRC Program Principal Investigator/Program Director (Last, First, Middle): GARCIA, Hector H. Component 2 - Biomarkers for Monitoring Treatment Efficacy in Human Neurocysticercosis PROJECT SUMMARY Human neurocysticercosis (NCC) is a frequent cause of seizures and other neurological disease in most developing countries also present in industrialized countries because of travel and immigration from endemic regions. Treatment of NCC involves symptomatic measures as well as interventions to destroy (antiparasitic treatment) or excise the parasites (surgical procedures). The efficacy of these interventions is usually monitored by neuroimaging techniques, computed tomography (CT) or magnetic resonance imaging (MRI), that are performed three or six months after treatment. The response rate to antiparasitic drugs is currently poor and the decision to retreat is frequently delayed until clinical relapse and/or obvious regrowth, which would be expected to lead to increased risk for complications and likely a more difficult course of retreatment. In addition, CT and MRI are expensive and not accessible in poor rural areas, where NCC is highly endemic. There is thus is an important need for an assay for early documentation of the response to therapy. Given the variability of clinical presentations of NCC, a single test or a time point in the follow up may not be the best choice for all scenarios. This component will attempt to develop one or more assays for early assessment of response to treatment in the main types of NCC, taking advantage of newly available test formats and our vast collection of archive samples in addition to additional prospectively collected baseline and post-treatment serum and urine samples to define a test, a sample and the time point of choice to better predict partial and complete responses to treatment for each of the main types of NCC.